BMJ  2004;328:288-289 (31 January), doi:10.1136/bmj.328.7434.288-d

Letter

Colchicine in acute gout

Low dose colchicine was started after usual dose

The first 150 words of the full text of this article appear below.

EDITOR—Morris et al emphasise that in acute gout lower doses of colchicine are effective yet less toxic than traditional regimens.¹ Certain points need, however, to be considered.

In all the three cases quoted the patients initially started taking higher (traditional) doses of colchicine and only after they had experienced adverse effects were their doses reduced. This means a lingering effect of colchicine would be present. Evidence shows that colchicine will be present in leucocytes (site of action) for at least nine days after a single intravenous dose.² To claim that a lower dose of colchicine is effective, should one not start with a lower dose?

Because toxicity is more common with colchicine, non-steroidal anti-inflammatory drugs (NSAIDs, such as indomethacin or naproxen) are preferred.² In one of the three cases mentioned, meloxicam was tried without benefit. Meloxicam is a drug with a long half life, and it needs time . . . [Full text of this article]

Chengalpattu Medical College, Chengalpattu, Tamil Nadu 603 001, India drsivagnanam@hotmail.com

CiteULike    Complore    Connotea    Del.icio.us    Digg    Reddit    StumbleUpon    Technorati    What's this?

Relevant Articles

Colchicine in acute gout: Authors' reply

Ian Morris, George Varughese, and Peter Mattingly
BMJ 2004 328: 289. [Extract] [Full Text]

Colchicine in acute gout

Ian Morris, George Varughese, and Peter Mattingly
BMJ 2003 327: 1275-1276. [Extract] [Full Text] [PDF]

This article has been cited by other articles:

• Dietrich, A. J, Oxman, T. E, Williams, J. W Jr, Schulberg, H. C, Bruce, M. L, Lee, P. W, Barry, S., Raue, P. J, Lefever, J. J, Heo, M., Rost, K., Kroenke, K., Gerrity, M., Nutting, P. A (2004). Re-engineering systems for the treatment of depression in primary care: cluster randomised controlled trial. BMJ 329: 602- [Abstract] [Full text]  

Online poll

Find out more>>